Culture shock/clash in Rural Medicine

[SXMMD]

Was just having a discussion among colleagues about practicing rural family medicine. We're a pretty diverse bunch, but very few of us come from truly rural backgrounds and are ignorant of how much/little cultural diversity one can expect in rural America (I suppose this will vary by location). The most "rural" experience I have is having completed undergraduate education in central Cali (Merced), although with it's proximity to the Bay Area, Sacramento, Fresno, Modesto etc I never really felt it to be all that isolated/rural. Atwater on the other hand...

In your experiences, how diverse are rural communities? Is lack of diversity and fear of not being accepted due to being of a different ethnicity/religion/culture than the communities you wish to practice in ever something to worry about?

Would love to hear some thoughts!

P.S.
Upon review, the title does not quite correlate to the question asked, my apologies!

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[NurWollen]

I'm hoping @cabinbuilder gets on here with some persective on what rural is. I haven't spent any time there, but just looking at demographic information Merced isn't 'rural,' not by any stretch of the imagination. Nor does it lack ethnic diversity. Then again, I don't imagine it's much of an exciting place, either, so I can see where you're coming from.

 

[cabinbuilder]

I would agree that Merced, CA is NOT rural by any stretch of the imagination. I drive through there about every 3 months on the way to Vegas. Yes, I come from a truly rural background - it would be considered frontier (a town of 500 in central Alaska). Diversity in a rural community depends on the history of said community and the nature of it's coming to existence. How old the town is, etc. @SXMMD, you will need to elaborate on any specific questions. I work in the rural West and in Texas.

 

[deleted6669]

the big culture shock I see in rural environments is when folks realize they can't just hand off a pt to a specialist as soon as they find a problem in that specialty.
no urology? guess what? you have to do the phenylephrine injection into the cavernosum for priapism. no ortho? that closed reduction or tough shoulder dislocation is all you. no plastics? get comfy, you have a 3 hr complex facial lac repair ahead of you...I think the rural environment stretches clinicians to become their best. there are some things you will still need to ship hours away to a specialist(especially operative stuff, cath lab, etc), but often the best you can do is get one on the phone, get their input, and do the procedure yourself. I work in 2 rural depts, one small enough that I am there by myself working 24as in which I see a max of 14-15 pts, and love the challenges of rural medicine. As far as actual culture shock, I see a much narrower band of folks on the socioeconomic spectrum at my rural jobs- more unemployed, on medicaid, blue collar type folks, etc than at my job at an inner city trauma center. I think these folks think about coming into the ER more than folks in the city so tend not to come in until they are sicker than the city folks...which makes my job there a lot more enjoyable. treating real illness all day trumps dealing with the worried well with 15 min of nasal congestion any day.